{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T16:10:35Z","timestamp":1784391035037,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81670136"],"award-info":[{"award-number":["81670136"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Studies of the association between body mass index (BMI) at diagnosis and treatment outcome in children with acute lymphoblastic leukemia (ALL) have yielded inconsistent results. Hence, we conducted a retrospective study in a large cohort of Chinese children with ALL treated with contemporary protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>A total of 1437 children (62.1% male; median age at diagnosis 5.7\u2009years, range: 2.3\u201316.3\u2009years) were enrolled in two consecutive clinical trials at the Shanghai Children's Medical Center. The rates of overall survival, event\u2010free survival, relapse, treatment\u2010related mortality, and adverse events were compared among patients who were underweight (BMI\u2009&lt;\u20095th percentile), at a healthy weight (5th to 85th percentile), overweight (&gt;85th to &lt;95th percentile), and obese (\u226595th percentile).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At diagnosis, 91 (6.3%) patients were underweight, 1070 (74.5%) were at a healthy weight, 91 (6.3%) were overweight, and 185 (12.9%) were obese. No significant association was found between weight status and 5\u2010year overall survival, event\u2010free survival, or relapse in the overall cohort. When analyzed as a continuous variable, a higher BMI Z\u2010score was associated with treatment\u2010related mortality (hazard ratio 1.33 (95% confidence interval [CI], 1.05\u20131.68%), <jats:italic>p<\/jats:italic>\u00a0=\u20090.02). The treatment\u2010related mortality rate was higher in the overweight (5.5%, 95% CI 0.8\u201310.2%) and obese (3.2%, 95% CI 0.6\u20135.8%) groups compared with the underweight (0.0%) and healthy\u2010weight groups (1.9%, 95% CI 1.1\u20132.7%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04). Multivariable analysis showed that children who were overweight had a higher risk of treatment\u2010related mortality (hazard ratio 3.8, 95% CI 1.3\u201311.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While body weight status was not associated with event\u2010free survival or overall survival, overweight patients were at higher risk of treatment\u2010related mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5188","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T06:29:18Z","timestamp":1664346558000},"page":"2850-2860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association between body mass index at diagnosis and outcomes in Chinese children with newly diagnosed acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"12","author":[{"given":"Wenting","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin Ting","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjing","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benshang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiliang","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longjun","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology and Oncology of China Ministry of Health, National Children's Medical Center, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Key Laboratory of Pediatric Hematology 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